320 4th St ACRS24-0103 rS MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS24-0103
'' • � ISSUED:
WI 9,- CITY OF ATLANTIC BEACH EXPIRES:
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
MECHANICAL RESIDENTIAL
320 4TH ST HVAC 1 HVAC 1 A/C 4 ton $4638.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169815 0100 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
Air Source America DBA JACKSONVILLE
207 20th ST N FL 32250
Buehler Air Conditioning BEACH
OWNER: ADDRESS: 1 CITY: STATE: ZIP:
COSTA JOSEPH ANTHONY 320 4th St ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
Issued Date: 1 of 1
•
**ALL INFORMATION
g 'i• , Mechanical Permit Application rHLIGHTED' 'IN
w `` 1 Itolltox, City of Atlantic Beach Building Department G 'IS-REQUIRED.
' C` 800 Seminole Road, Atlantic Beach, FL 32233
--Olt D.? Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#.:4C�• y —Olo
JOB ADDRESS: 32O 4-141 3 r ee filq ' :1123,5 PROJECT VALUE $ 4 44 i OC>
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (R&QUIRED)
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) �0 77318;
0 Air Handling Equipment Only ❑ Condenser Only IXAir Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 4
Heat: Unit Quantity / BTU's Per Unit ilteX(? Seer Rating (REQUIRED) )(c,
Duct Systems: Total CFM
El FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 1 set of digital plans)
Fire Standpipe Quantity (Requires 1 set of digital plans)
Underground Fire Main Value (Requires 1 set of digital plans)
Fire Hose Cabinets Quantity (Requires 1 set of digital plans)
Commercial Hoods Quantity (Requires 1 set of digital plans)
Fire Suppression Systems Quantity (Requires 1 set of digital plains)
LI FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
HALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems I
Tanks (gallons)
Wells
OTHER:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned f r six months. I hereby
certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this
work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or
local law regulation construction or the performance of construction.
Owner Name:. Tone f ) CA54q Phone Number: 00(1) - 4357
Mechanical Company: 80e.1ile/2 Air CM/il 0).1 Office Phone: e.--;'j - l Fax
Co. Address: . ;.77SU*/:: 1.-I' './ree,/ /V City: ,• c nu/' 46-6/7 State: ,�.. Zip: `j.AA
License Holder: .71-736A1 J� ' State Certi ication/Registration# CAC— /6/67.y
Notarized Signature of License Holder di
The foregoinginstrument was acknowle. • before me this /841 da of / C( 2Q0 in
County of uVet/ Y �, the St to of Florida,
Signature of Notary Public 0 tY.-cy'te A
Notary Public State of Florida
1 Korie Diane Hall %Personally Known OR [ ] Produced Identification
1 im. ,,, My Commission HH 445966 Type of Identification:
I Expires 9/20/2027 i
Updated 10/11/23
driLi. r
�s'
_ Cash Register Receipt Receipt Number' �� City of Atlantic Beach R26556
''''CJii19'' rte_
PermitTRAK $115.00
ACRS24-0103 Address: 320 4TH ST APN: 169815 0100 $115.00
MECHANICAL $111.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 4 $32.00
FURNACES AND HEATING 455-0000-322-1000 48000 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R26556 $115.00
Date Paid:Thursday, March 21, 2024
Paid By: Air Source America DBA Buehler Air Conditioning
Cashier: SC
Pay Method: CREDIT CARD 10160198255
Printed:Thursday, March 21,2024 4:06 PM 1 of 1 Cif, CENTRALSQUARE